The U.S. Department of Health and Human Services (HHS) released additional
Senators Durbin and Lankford Take to the Senate Floor to Speak on Behalf of the Needs of Rural Hospitals
Senators Richard Durbin (D-IL) and James Lankford (R-OK) discussed the challenges facing rural hospitals in the wake of COVID-19 on the Senate floor. These senators helped s
Case Study: Iowa’s I-Smile Program Promoting Dental Care
A unique partnership between the Iowa Medicaid and public health agencies, Iowa’s I-Smile program addresses the disproportionate impact of dental disease on low-income individuals and families. The initiative is supported through cooperative agreement between the National Organizations of State and Local Health Officials and the Health Resources and Services Administration. Read more here.
HHS Study: Strategies Rural Communities Use to Address Substance Misuse Among Families In The Child Welfare System
The Office for Planning and Evaluation at the U.S. Department of Health & Human Services (HHS) describes nine programs serving child welfare-involved parents with substance use issues, with a particular focus on their applicability to rural communities. These programs offered various types of services, including parent mentoring, case management, home visiting, and treatment for opioid use disorders. Read more here.
ASPE Issue Brief: Medicare Beneficiary Use of Telehealth Visits: Early Data From The Start Of The Covid-19 Pandemic
On July 28, the HHS Office of the Assistance Secretary for Planning and Evaluation (ASPE) released an issue brief examining changes in Medicare fee-for-service primary care visits and use of telehealth at the start of the COVID-19 public health emergency (PHE). This brief seeks to address the issue of how and whether the Medicare telehealth flexibilities introduced to address the COVID-19 pandemic may have helped maintain access to primary health care during the PHE. The analysis found Medicare primary care visits dropped precipitously from mid-March at the start of the pandemic, at the same telehealth visits increased for primary care. However, telehealth use was lower in rural areas.
Changes in Care-Seeking after Rural Hospitals Merge
Researchers at the North Carolina Rural Health Research and Policy Analysis Center examined 15 rural hospitals to estimate the change in use of inpatient services delivered by acquired rural hospitals following a merger. Read more about the findings here.
Rural Response to Coronavirus Disease 2019
The Rural Health Information Hub posted a guide to help you learn about activities underway to address COVID-19. New: Rural Healthcare Surge Readiness a tool developed by the COVID-19 Healthcare Resilience Working Group that helps rural healthcare facilities prepare for and respond to a COVID-19 surge. The tool provides the most up-to-date resources for rural healthcare systems preparing for and responding to a COVID-19 surge in a range of healthcare settings (EMS, inpatient and hospital care, ambulatory care, and long-term care) and covers a range of topics including behavioral health, healthcare operations to telehealth, and more.
HHS Coronavirus Data Hub
Last week, the U.S. Department of Health & Human Services (HHS) launched a website with data on the COVID-19 response at federal, state, and local levels. The hub includes estimated and reported hospital capacity by state, with numbers updated daily.
Appeals Court Upholds Nearly 30% Payment Cut to 340B Hospitals
Fierce Healthcare
A federal appeals court has ruled the Trump administration can install nearly 30% cuts to the 340B drug discount program.
The ruling Friday is the latest legal setback for hospitals that have been vociferously fighting cuts the Department of Health and Human Services (HHS) announced back in 2017.
340B requires pharmaceutical manufacturers to deliver discounts to safety net hospitals in exchange for participation in Medicaid. A hospital will pay typically between 20% and 50% below the average sales price for the covered drugs.
HHS sought to address a payment gap between 340B and Medicare Part B, which reimburses providers for drugs administered in a physician’s office such as chemotherapy. There was a 25% and 55% gap between the price for a 340B drug and on Medicare Part B.
So HHS administered a 28.5% cut in the 2018 hospital payment rule. The agency also included the cuts in the 2019 payment rule.
Three hospital groups sued to stop the cut, arguing that HHS exceeded its federal authority to adjust the rates to the program.
A lower court agreed with the hospitals and called for the agency to come up with a remedy for the cuts that already went into effect.
But HHS argued that when it sets 340B payment amounts, it has the authority to adjust the amounts to ensure they don’t reimburse hospitals at higher levels than the actual costs to acquire the drugs.
If the hospital acquisition cost data are not available, HHS could determine the amount of payment equal to the average drug price. HHS argued that hospital cost acquisition data was not available and so HHS needed to determine the payment rates based on the average drug price.
The court agreed with the agency’s interpretation.
“At a minimum, the statute does not clearly preclude HHS from adjusting the [340B] rate in a focused manner to address problems with reimbursement rates applicable only to certain types of hospitals,” the ruling said.
The court added that the $1.6 billion gleaned from the cuts would go to all providers as additional reimbursements for other services.
340B groups were disappointed with the decision.
“These cuts of nearly 30% have caused real and lasting pain to safety-net hospitals and the patients they serve,” said Maureen Testoni, president and CEO of advocacy group 340B Health, which represents more than 1,400 hospitals that participate in the program. “Keeping these cuts in place will only deepen the damage of forced cutbacks in patient services and cancellations of planned care expansions.”
This is the latest legal defeat for the hospital industry. A few weeks ago, the same appeals court ruled that HHS had the legal authority to institute cuts to off-campus clinics to bring Medicare payments in line with physician offices, reversing a lower court’s ruling.
The groups behind the lawsuit — American Hospital Association, American Association of Medical Colleges and America’s Essential Hospitals — slammed the decision as hurtful to hospitals fighting the COVID-19 pandemic. But the groups didn’t say if it would appeal the decision.
“Hospitals that rely on the savings from the 340B drug pricing program are also on the front-lines of the COVID-19 pandemic, and today’s decision will result in the continued loss of resources at the worst possible time,” the groups said in a statement Friday.
Pennsylvania Dashboard Data Shows Weekly COVID Case Increases Statewide, Multiple Counties with High Percent-Positives
Pennsylvania Governor Tom Wolf released a weekly status update detailing the state’s mitigation efforts based on the COVID-19 Early Warning Monitoring System Dashboard comparing the seven-day period of July 24 – July 30 to the previous seven days, July 17 – July 23.
The dashboard is designed to provide early warning signs of factors that affect the state’s mitigation efforts. The data available on the dashboard includes week-over-week case differences, incidence rates, test percent-positivity, and rates of hospitalizations, ventilations and emergency room visits tied to COVID-19.
“The mitigation efforts we took on July 15 were a proactive step to get in front of the rise of cases that we continue to see,” Gov. Wolf said. “Our percent positivity decreased this week, which is a positive sign, but in order to continue to see numbers decrease, we must continue to wear masks and practice social distancing.
“Going out without a mask and congregating at a bar or in a crowded backyard party where social distancing isn’t being practiced continues to lead to spikes in cases. We need to recommit to these simple measures to stop the spread and go back to more freedoms.”
As of Thursday, July 30, the state has seen a seven-day case increase of 6,228, the previous seven-day increase was 6,010, alerting that cases are continuing to rise throughout the state.
The statewide percent-positivity went down to 4.6% from 4.7% last week. Counties with concerning percent-positivity include Lawrence (7.4%), Franklin (7.2%), Indiana (7.2%), Fayette (7.1%), Armstrong (7.0%), Beaver (6.5%), Delaware (6.5%), Allegheny (6.4%), Lancaster (5.8%), Berks (5.6%), Philadelphia (5.4%) and Chester (5.3%). Each of these counties bear watching as the state continues to monitor all available data.
The Department of Health updated its travel recommendations, originally announced on July 2, to remove Wyoming to the list of states recommended for domestic travelers returning from to quarantine for 14 days upon return to Pennsylvania.
It is important that people understand that this recommendation is in place to prevent the spread of COVID-19 in Pennsylvania. A significant number of recent cases have been linked to travel, and if people are going to travel, we need them to take steps to protect themselves, their loved ones and their community, and that involves quarantining.
Gov. Wolf continues to prioritize the health and safety of Pennsylvanians through the COVID-19 pandemic. Pennsylvanians should continue to take actions to prevent the spread of COVID-19, regardless of the status of their county. This includes wearing a mask or face covering anytime they are in public. COVID-19 has been shown to spread easily in the air and contagious carriers can be asymptomatic.